Long-term clinical benefit of a platelet glycoprotein IIb/IIIa receptor blocker (Abciximab: $ReoPro^{\circledR}$ ) in diabetic patients undergoing high-risk percutaneous coronary intervention
2002
Background: High-risk percutaneous coronary interventions (PCI) are associated with high complication rate, low procedural success rate and high restenosis rate, especially in diabetics. We sought to observe whether diabetes affects long-term clinical outcomes after Abiciximab () therapy in Korean patients undergoing high-risk PCI. Methods: One hundred nineteen patients with 152 lesion sites were administered out of 2,231 patients who underwent PCI at Chonnam National University Hospital from Mar 1999 to Feb 2001. They were divided into two groups, 30 in diabetic group (Group Ⅰ, 57.78.2 years, 22 male) and 89 in non-diabetic group (Group Ⅱ, 59.610.8 years, 68 male). Early and long-term clinical outcomes after PCI were analyzed. Results: In clinical diagnosis the number of acute myocardial infarction was 25 in Group Ⅰ (83.3%) and 76 in Group Ⅱ(85.4%). As for risk factors and target lesion artery, ACC/AHA types, there were no differences between the two groups. The number of patients with total occlusion was 21 (55.3%) and 62 (53.9%) and thrombus-containing lesion 28 (93.3%) and 88 (98.9%) in Group Ⅰ and Ⅱ respectively. Procedure was successful in 27 (90.0%) in Group Ⅰ and 80 (98.9%) in Group Ⅱ and there were no differences in bleeding complications. No major adverse cardiac events (MACE), including myocardial infarction, repeat revascularizaton or cardiac death were observed in Group Ⅰ, but there were 8 cases of MACE in Group Ⅱ during hospitalization. Clinical follow-up was performed in 116 patients (97.5%) during 18.56.7 (5-28) months. The number of overall MACEs were 10 (3.3%) in Group Ⅰ and 14 (15.7%) in Group Ⅱ(p=0.038). Conclusion: used in high-risk PCI in diabetics was effective in early clinical outcome, but long-term clinical benefits were not warranted.
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